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Cardio Vascular Year 1 > Valvular heart disease > Flashcards

Valvular heart disease Flashcards

1
Q

What is aortic regurgitation

A

reflux of blood from the aorta through the aortic valve into the left ventricle during diastole

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2
Q

What can be the reasons for Aortic regurgitation

A

Valve disease
Aortic root disease

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3
Q

What valve disease can cause aortic regurgitation

A

Rheumatic fever
Infective endocarditis
Connective tissue disease (RA/SLE)
Bicuspid aortic valve

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4
Q

What aortic root disease can cause aortic regurgitation

A

Aortic dissection
Spondylarthropathis
Hypertension
Marfan’s
Ehler-Danlos syndrome
Syphilis

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5
Q

What are the symptoms for aortic regurgitation

A

Significant symptoms occur late do not develop until LV failure develops
Angina
Dyspnoea

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6
Q

What murmur is a sign for aortic regurgitation and how is it best heard

A

High pitched early diastolic murmur best heard at the left sternal edge in fourth intercostal space when patient is leaning forward and breath is held in expiration

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7
Q

What are other signs for aortic regurgitation

A

Collapsing pulse
Apex beat is displaced laterally and downwards and forceful in quality

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8
Q

What are the investigations for aortic regurgitation

A

ECG
CXR
Echocardiogram key for diagnosis and severity
CMR - secondary
Cardiac catheterisation - secondary

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9
Q

What is the medical therapy for aortic regurgitation

A

Treat underlying cause
If acute may need vasodilators and in tropes
ACE inhibitors for chronic AR and HF
Beta-blockers may slow aortic dilation in Marfan’s patients

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10
Q

What is the surgical management of aortic regurgitation

A

Indicated in symptomatic and asymptomatic patients when LV function begins to deteriorate
-> Valve replacement

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11
Q

What is aortic stenosis

A

Aortic valve is too small, narrow or stiff resulting in obstruction of blood flow from left ventricle to aorta during systole

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12
Q

What is the reason for Aortic stenosis in young patients

A

Usually from congenital bicuspid valve (birth defect)

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13
Q

What is the reason for Aortic stenosis in old patients

A

Usually from calcifications on aortic valve or rheumatic heart disease is next most common

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14
Q

When do symptoms start and what are they in aortic stenosis

A

Usually no symptoms until aortic stenosis is moderately severe then:
Exercise-induced syncope, angina and dyspnoea develop

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15
Q

describe the murmur that is a sign for aortic stenosis

A

Ejection systolic murmur best heard at 2nd right intercostal space right sternal edge (aortic area)
Radiates to carotids

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16
Q

What are the investigations for aortic stenosis

A

CXR
ECG
Echocardiogram
If indicated: CMR, cardiac CT

17
Q

What is the management of aortic stenosis

A

Conventional valve replacement (preferred)
Patients that don’t tolerate operation under anaesthesia: TAVI

18
Q

What is Mitral Regurgitation

A

Occurs when blood leaks back through mitral valve during systole

19
Q

What can be the causes for Mitral regurgitation

A

Primary valve disorder
Secondary to left ventricular dysfunction

20
Q

What are examples of primary valve disorders

A

Infective endocarditis
MI causing valve prolapse
Rheumatic fever

21
Q

What are symptoms of Mitral regurgitation

A

Dyspnoea
Peripheral oedema
Fatigue

22
Q

What murmur is a sign for mitral regurgitation

A

Pan-systolic murmur best heard at apex (5th intercostal space in left midclavicular line) radiating to the axilla

23
Q

What is another sign for mitral regurgitation

A

Displaced apex

24
Q

What are the investigations for mitral regurgitation

A

CXR
ECG
Echocardiogram-conform diagnosis and severity
If indicated - CMR, coronary angiography

25
Q

What is the medical management for mitral regurgitation

A

Diuretics
ACEi if HF develops

26
Q

What is the surgical management for mitral regurgitation

A

Open heart surgery and valve repair or replacement
MitraClip if can’t tolerate open heart surgery

27
Q

What is mitral stenosis

A

Occurs when there is obstruction to the floe through the mitral valve during diastole

28
Q

What are the causes of mitral stenosis

A

Rheumatic fever
Calcification related to age
Congenital

29
Q

What are the symptoms of mitral stenosis

A

Dyspnoea
Fatigue
Palpitation

30
Q

What causes the palpitation in mitral stenosis and what can it cause

A

Mitral stenosis causes pressure in left atria to remain elevated so atria enlarges -> can cause atrial fibrillation

31
Q

What are the signs of mitral stenosis

A

Mid-diastolic murmur best heart at apex beat
Malar flush
Tapping apex beat

32
Q

What are the investigations for mitral stenosis

A

CXR
ECG
Echocardiogram - severity

33
Q

What is the medical treatment of mitral stenosis

A

Diuretics
Treat AF

34
Q

What is the surgical treatment of mitral stenosis

A

Valve replacement
Balloon valvuloplasty if can’t tolerate valve replacement

35
Q

What is a Innocent (functional) murmur

A

A murmur which is not indicative of underlying pathology

36
Q

Who typically develops a innocent murmur

A

Children, young adults and pregnant people

37
Q

How would you describe the murmur indication a innocent murmur

A

Soft, early systolic, short and non-radiating

Cardio Vascular Year 1 (23 decks)

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